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Haemostasis & Thrombosis > Fibrinolysis > Flashcards

Fibrinolysis Flashcards

1
Q

what is fibrinolysis dependent on?

A

Plasminogen (zymogen inactive precursor

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2
Q

What domains does plasminogen have an affinity for?

A

Kringle domains on cell surface & clot

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3
Q

What 2 things can activate plasminogen?

A

tPA
urokinase

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4
Q

What is the activated form of plasminogen called?

A

plasmin

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5
Q

Where is tPA and urokinases released from?

A

Damaged ECs

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6
Q

What inhibits conversion of plasminogen to plasmin?

A

PAI (derived from platelets)

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7
Q

What factors from coagulation also promote fibrinolysis?

A

Factor XIa
Factor XIIa
Kallikrein

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8
Q

What are the main fibrin breakdown products?

A

D-dimers
E-fragments

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9
Q

What is used to measure D-dimer content in blood?

A

Specific antibodies against D-dimers

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10
Q

What 2 diseases are associated with high levels of D-dimers?

A

DVT
pulmonary embolism

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11
Q

What organ produces plasminogen/

A

Liver

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12
Q

What are 3 other anti-fibrinolytic agents?

A

alpha 2 antiplasmin
alpha 2 macroglobulin
thrombin

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13
Q

What activates tPA?

A

Binding to fibrin (localised activation)

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14
Q

What does partial fibrin degradation causes?

A

Exposes further tPA binding sites -> positive feedback loop

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15
Q

What are tPA and uPA?

A

Serine proteases that cleave plasminogen

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16
Q

What are PAIs?

A

Serine protease inhibitors (serpins) that reduce tPA & uPA

17
Q

What is tPA in an inactive complex with?

A

PAI-1

18
Q

where is alpha2-antiplasmin synthesized?

A

Liver

19
Q

What incorporates alpha2AP into the clot?

A

factor XIII

20
Q

What happens if alpha2AP is incorporated into the clot?

A

Prevents & delays degradation of fibrin clot (permits vessel repair processes)

21
Q

What are 3 commonly used thrombolytics?

A

Streptokinase
urokinase
recombinant tissue plasminogen activators

22
Q

What are 4 disease where thrombolysis is used?

A

Myocardial infarction
stroke
massive pulmonary embolism
acute limb ischaemia

23
Q

What are 4 types of acquired hyperfibrinolysis?

A

metabolic syndrome (elevated PAI)
trauma/surgery
inflammation
treated with anti-fibrinolytis

Haemostasis & Thrombosis (17 decks)

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